The Second International Nuss Procedure Workshop – Istanbul

Report

Dear Colleagues,

The second Nuss Procedure Workshop, this time  depicted as International, had been held successfully on 26-27th June 2009 at Marmara University Hospital; that the first one we had organised   in İzmir in June 2008 had been Internationally participated also.

The workshop was arranged by the cooperation of the Departments of Thoracic Surgery of Marmara University and Dokuz Eylül University Medical Faculties; the Minimally Invasive Surgical Techniques, on the basis of inserting metal bars in front of and behind the sternum for the congenital chest wall deformities (pectus carinatum and excavatum), were discussed and debated by the registration and participation of 100 academicians.The thirty of  a hundred attended from USA, Latin America, Africa, Far East and various countries in Europe.

The workshop initiated on  Friday morning on 26th June 2009, by the operations of four cases with pectus deformity that the participants were able to watch the operation room  live from the conference hall by the tele-conference system momentously at the session which was directed and anchored by Prof.Dr. Nezih Özdemir, Prof.Dr.Hans Pilegaard and Asc.Prof.Dr. Hasan Fevzi Batırel. Firstly a 14-year-old male patient had been operated. One pectus bar had been inserted for this patient with the Nuss technique. The second case was a 13-year-old male pectus excavatum case and the third patient was a 19-year-old patient; a recurrent pectus excavatum case who had been operated by modified Ravitch method previously in 2006. Single pectus bars were used for each case. Finally a 14-year-old male patient with pectus carinatum  deformity was operated with the Abramson technique and a single bar was inserted also. The operations were completed successfully which had been  interactively contributed by the participants as well. Following the lunch academical sessions began.

In the first session that Prof.Dr. Mustafa Yüksel and Prof.Dr. Laureano Mollins had anchored, the pioneers of the thoracic surgery had shared their experiences with the participants,  about the correction of  congenital chest wall deformities. The speech of world-famous cardiovascular and thoracic surgeon, Francis Robicsek about his experiences of fifty years attracted great attention. Subsequently, Prof.Dr. Şinasi Yavuzer, the most experienced surgeon on this topic in Turkey shared his experiences of 50 years. Then, Hans Pilegaard ,the surgeon who had the largest Nuss Procedure  case series in Europe, presented his modifications on this procedure and  his series that reached  to 700 cases.

In the next session the topic was Turkish Experience in Minimal Invazive Pectus Surgery. By the anchoring of Prof.Dr.Şinasi Yavuzer and Asc.Prof.Dr. Mehmet Bilgin; Prof.Dr. Mustafa Yüksel shared his experience of Nuss Procedure on 110 cases at Marmara University. Then Ass.Prof.Dr. Ahmet Önen shared his experience of 70 cases on Nuss and Abramson Procedures at Dokuz Eylül University and  next Prof.Dr. Kamil Kaynak shared 140 cases of Nuss procedure experience of Cerrahpaşa Medical Faculty,  with the participants. In the last session of the day by the anchoring of Prof.Dr.Kamil Kaynak and Dr.Horacio Abramson from Argentina, ''the senior  clinical chief who had first performed the Abramson Technique for Pectus Carinatum''; Asc.Prof.Dr. Jose Ribas Milanez De Campos lectured about the modifications he had innovated. Following him, Prof.Dr. Laureano Mollins informed the participants about the Nuss procedure practices in Spain generally.

After the last session of the day, the participants departed from the Marmara University Conference Hall for the Gala Dinner. In this dinner which was conceived in the concept of ''A Boat Trip along the Bosphorus”, the guests assessed the whole evening while having their drinks, alcohol and enjoyed themselves after the fish barbecue.

On Saturday The second day of the workshop began  at 08:30. The first session was on the topic of Correction of Pectus Deformities by the open techniques. Senior Clinical Chief from Brazil; Dr.Pasqhual Napolitano Neto and Prof.Dr. Francis Robiscek anchored the session. Subsequent to the lecture of Asc.Prof.Dr. Onur Genç about the correction operations wich had been  performed on 380 cases with pectus deformity by the open technique at Gülhane Military Medical Faculty(GATA), Op.Dr.Amulya Saxena displayed and defined, the new PLIER technique he had explored, to the participants and he shared his own experience over 40 cases. The last lecturer was Prof.Dr. Hans Pilegaard and he mentioned about the open pectus carinatum correction surgery he performed by using LactoSorb.
            The second session of the day was about the alternative techniques in pectus carinatum correction surgery and held by the anchoring of Asc.Prof.Dr. Jose Ribas Milanez de Campos and  Op.Dr.Andras Hock from Hungary. The clinical chief  Dr.Horacio Abramson, who had blazed a trail by the Minimally Invazive Correction Surgery on  pectus carinatum deformity which is depicted as the the Abramson Procedure; shared his experience and his case series over 60 patients. Then Op.Dr.Korkut Bostanci shared the Marmara University experience on the 15 cases of pectus carinatum, the second center in the world performing the Abramson procedure, subsequent to Abramson himself. The last lecturer of the session was Op.Dr.Andreas Hock and he shared his experience on the new minimally invazive technique  he had described for the correction  of pectus carinatum.

The first session in the afternoon was anchored by Prof.Dr. Hans Pilegaard and Op.Dr. Amulya Saxena and two case reports were presented from Latin America.
Clinical Chief Dr.Pasqhual Napolitano Neto lectured on his own experiences on minimally invasive pectus excavatum correction surgery and Marlos de Souza Coelho from Brazil shared also his own experience  of Nuss procedure and sternocondroplasty for the correction of pectus excavatum.

Next, at the mini-symposium, the oral presentations were reported. Op.Dr. Frank Martin Haecker from  Switzerland shared his experiences of Vacuum Bell method on pectus excavatum deformity. Then Op.Dr.Sergey Rodakov from Russia, mentioned about his series of 150 cases that he had performed correction surgery by the minimal invazive technique by using smart metals with memory. Next, Op.Dr. Ali Zamir Khan lectured on his  experience of 8 years of Nuss Procedure and then Asc.Prof.Dr. Mehmet Bilgin presented his experience at Erciyes university on correction of pectus excavatum. Finally Dr.Ivan Schewitz shared his own experience on over 20 cases with the participants.

At the final session of the day and the workshop, the difficult cases were discussed. The session was anchored by Prof.Dr. Hans Pilegaard, Asc.Prof.Dr. Alper Toker and Ass.Prof Dr. Ahmet Önen and firstly Prof Dr Mustafa Yüksel shared the postoperative photos of 4 cases who had been operated the previous day and informed the participants about the recent general status of these patients. Following this, he shared  opinions with the participants and debated about two cases; a pectus carinatum and a pectus excavatum case, previously operated, who had problems at the postoperative period. 

Dr.Pilegaard, Dr.Milanez de Campos and Dr.Napolitano presented their difficult cases as well and especially the strategies that should be followed on the cases with metal allergy was debated interactively.

Therefore, the two day workshop which had been held in high academic level and included complex academic debates had succeeded to an end. It was announced by Prof.Dr. Mustafa Yüksel at  the  closing speech of the workshop, the third International Nuss Procedure Workshop was going to be held in Izmir on 27-28th June 2010 and the  participants were invited for this appointment.

At  night an invitation at Circle d’Orient was organised by Prof.Dr. Mustafa Yüksel for the invited lecturers  to enjoy the dinner by the fascinating beauty of the Marmara Sea.